National Provider Identifier [NPI]: |
1740221225 |
Last Name Of The Provider |
ZIMMERMANN |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2490 S WOODWORTH LOOP |
Street Address 2 Of The Provider |
#499 |
City Of The Provider |
PALMER |
Zip Code Of The Provider |
996457405 |
State Code Of The Provider |
AK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
90 |
Number Of Services |
23807 |
Number Of Medicare Beneficiaries |
194 |
Total Submitted Charge Amount |
4803029.93 |
Total Medicare Allowed Amount |
488120.03 |
Total Medicare Payment Amount |
377795.79 |
Total Medicare Standardized Payment Amount |
366916.21 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
50 |
Number Of Drug Services |
22093 |
Number Of Medicare Beneficiaries With Drug Services |
63 |
Total Drug Submitted ChargeAmount |
4373630.83 |
Total Drug Medicare AllowedAmount |
392548.85 |
Total Drug Medicare PaymentAmount |
304404.24 |
Total Drug Medicare Standardized Payment Amount |
304404.24 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
40 |
Number Of Medical Services |
1714 |
Number Of Medicare Beneficiaries With Medical Services |
194 |
Total Medical Submitted Charge Amount |
429399.1 |
Total Medical Medicare Allowed Amount |
95571.18 |
Total Medical Medicare Payment Amount |
73391.55 |
Total Medical Medicare Standardized Payment Amount |
62511.97 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
109 |
Number Of Beneficiaries Age 75 to 84 |
51 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
102 |
Number Of Male Beneficiaries |
92 |
Number Of Non Hispanic White Beneficiaries |
175 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
144 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
50 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
|
Percent Of With Cancer |
55 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
36 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6279 |